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Abstract

Background: Atherosclerosis of carotid artery is associated with cerebrovascular and cardiovascular event. However, few studies have compared atherosclerosis of carotid artery with coronary CT angiography (CCTA) findings within the same population.

Objective: The aim of this study was to evaluate the association between CCTA and carotid ultrasound measures of atherosclerosis.

Methods: CCTA and carotid ultrasound were performed in 232 consecutive patients (66±10 years, 115 males) with suspected coronary artery disease. Coronary artery calcium score (CACS) was assessed by MSCT using Agaston method prior to CCTA. Normal CCTA was defined as no coronary artery plaque. Carotid plaque was defined as a focal region with IMT >1.0mm by carotid ultrasound. Carotid plaque score (CPS) was defined as the sum of all plaque heights in bilateral carotid arteries. Carotid stenosis was defined as a ≥70% reduction in diameter. All patients were classified as having (group 1) CACS=0, (group 2) 0<CACS<400, (group 3) 400≥CACS. CPS and presence of carotid stenosis among the 3 groups were compared using one way ANOVA followed by Tukey's test. The CCTA Results were compared with the value of CPS.

Result: CACS was significantly correlated with CPS (r = 0.33, p < 0.001). Eighty-five patients (36.7%) had a score of zero in CACS and 38 (16.4%) in CPS. Of 85 patients with CACS=0, 22 patients (25.9%) had no carotid plaque (CPS=0). Carotid stenosis was observed in 9 patients. Value of CPS and presence of carotid stenosis showed an increasing tendency in Group 2 and 3 when compared to Group 1 (Table 1). Normal CCTA was observed in 73 patients. Of 159 patients with any coronary plaque, 147 patients (92.5%) had carotid plaque, whereas all 73 patients with a normal CCTA had no carotid plaque (p = 0.031).

Conclusion: Patients with CACS=0 have no carotid stenosis. However, even in patients with CACS=0, nearly 75% had carotid plaque. Normal CCTA, but not CACS=0, is a strong negative predictor for carotid artery plaque.